一位因車禍導致壞死筋膜炎青少女之加護經驗

The Nursing Experience of Caring a Female Teenager with Necrotizing Fasciitis Following a Car Accident

本文探討在加護病房中照顧一位青少女因車禍導致壞死性筋膜炎術後的護理經驗。護理期間為2014年3月25日至4月10日，運用Gordon十一項健康功能型態評估工具為評估依據，藉由觀察、紀錄與個案會談等方式收集資料，發現個案有組織完整性受損、急性疼痛、身體心像紊亂等護理問題，而筆者針對個案的護理問題，擬定個別性護理計畫，以護理人員的專業知識和技能，透過護理活動的介入，運用同理心、系統性觀察及評估，協助個案藉由放鬆技巧緩解疼痛、提供傷口照護，並鼓勵以正面態度面對身體的改變，滿足個案基本的生理、心理需求，期望藉此護理經驗之分享，能提供急重症護理人員照護相關個案之參考。

In this article we want to share our nursing experience of caring a female teenager with necrotizing fasciitis following a car accident. She was admitted in ICU between March 25th and April 10th, 2014. After observation, recording and interviewing using the Gordon 11 Functional Health Patterns as an evaluation tool, we found challenges such as impaired skin integrity, acute pain, and body image disturbance. Personalized nursing plan on the basis of professional knowledge and skill was created. Through various nursing activities, systematic observation and evaluation, her pain was alleviated through relaxation exercise and ongoing wound care, and we encouraged her to confront physical change with a positive manner. We hope that the nursing experience could be a reference for those who may take care of similar cases in the future.